Dan K Kiely1, Dae Hyun Kim2, Alden L Gross3, Daniel A Habtemariam1, Suzanne G Leveille4, Wenjun Li5, Lewis A Lipsitz2. 1. Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Boston, MA. 2. Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Boston, MA; Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA. 3. Institute for Aging Research, Hebrew SeniorLife, Beth Israel Deaconess Medical Center, Boston, MA; Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA. 4. Division of General Medicine and Primary Care, Beth Israel Deaconess Medical Center, Boston, MA; College of Nursing and Health Sciences, University of Massachusetts, Boston, MA. 5. Division of Preventive and Behavioral Medicine, Department of Medicine, University of Massachusetts Medical School, Worcester, MA.
Abstract
OBJECTIVE: To determine whether previously reported racial differences in fall rates between White and Black/African American is explained by differences in health status and neighborhood characteristics. DESIGN: Prospective cohort. SETTING: Community. PARTICIPANTS: The study included 550 White and 116 Black older adults in the Greater Boston area (mean age: 78 years; 36% men) who were English-speaking, able to walk across a room, and without severe cognitive impairment. MEASUREMENTS: Falls were prospectively reported using monthly fall calendars. The location of each fall and fall-related injuries were asked during telephone interviews. At baseline, we assessed risk factors for falls, including sociodemographic characteristics, physiologic risk factors, physical activity, and community-level characteristics. RESULTS: Over the mean follow-up of 1,048 days, 1,539 falls occurred (incidence: 806/1,000 person-years). Whites were more likely than Blacks to experience any falls (867 versus 504 falls per 1,000 person-years; RR [95% CI]: 1.77 [1.33, 2.36]), outdoor falls (418 versus 178 falls per 1,000 person-years; 1.78 [1.08, 2.92]), indoor falls (434 versus 320 falls per 1,000 person-years; 1.44 [1.02, 2.05]), and injurious falls (367 versus 205 falls per 1,000 person-years; 1.79 [1.30, 2.46]). With exception of injurious falls, higher fall rates in Whites than Blacks were substantially attenuated with adjustment for risk factors and community-level characteristics: any fall (1.24 [0.81, 1.89]), outdoor fall (1.57 [0.86, 2.88]), indoor fall (1.08 [0.64, 1.81]), and injurious fall (1.77 [1.14, 2.74]). CONCLUSION: Our findings suggest that the racial differences in fall rates may be largely due to confounding by individual-level and community-level characteristics.
OBJECTIVE: To determine whether previously reported racial differences in fall rates between White and Black/African American is explained by differences in health status and neighborhood characteristics. DESIGN: Prospective cohort. SETTING: Community. PARTICIPANTS: The study included 550 White and 116 Black older adults in the Greater Boston area (mean age: 78 years; 36% men) who were English-speaking, able to walk across a room, and without severe cognitive impairment. MEASUREMENTS: Falls were prospectively reported using monthly fall calendars. The location of each fall and fall-related injuries were asked during telephone interviews. At baseline, we assessed risk factors for falls, including sociodemographic characteristics, physiologic risk factors, physical activity, and community-level characteristics. RESULTS: Over the mean follow-up of 1,048 days, 1,539 falls occurred (incidence: 806/1,000 person-years). Whites were more likely than Blacks to experience any falls (867 versus 504 falls per 1,000 person-years; RR [95% CI]: 1.77 [1.33, 2.36]), outdoor falls (418 versus 178 falls per 1,000 person-years; 1.78 [1.08, 2.92]), indoor falls (434 versus 320 falls per 1,000 person-years; 1.44 [1.02, 2.05]), and injurious falls (367 versus 205 falls per 1,000 person-years; 1.79 [1.30, 2.46]). With exception of injurious falls, higher fall rates in Whites than Blacks were substantially attenuated with adjustment for risk factors and community-level characteristics: any fall (1.24 [0.81, 1.89]), outdoor fall (1.57 [0.86, 2.88]), indoor fall (1.08 [0.64, 1.81]), and injurious fall (1.77 [1.14, 2.74]). CONCLUSION: Our findings suggest that the racial differences in fall rates may be largely due to confounding by individual-level and community-level characteristics.
Authors: Kimberly A Faulkner; Jane A Cauley; Joseph M Zmuda; Douglas P Landsittel; Michael C Nevitt; Anne B Newman; Stephanie A Studenski; Mark S Redfern Journal: J Am Geriatr Soc Date: 2005-10 Impact factor: 5.562
Authors: L P Fried; C M Tangen; J Walston; A B Newman; C Hirsch; J Gottdiener; T Seeman; R Tracy; W J Kop; G Burke; M A McBurnie Journal: J Gerontol A Biol Sci Med Sci Date: 2001-03 Impact factor: 6.053
Authors: Safiyyah M Okoye; Laura J Samuel; Chanee Fabius; John Mulcahy; Lisa M Reider; Sarah L Szanton; Jennifer L Wolff Journal: J Aging Health Date: 2021-04-20